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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />3/1/0 t; <br /> <br />JOB ADDRESS <br /> <br />/ II I. - - 0 'Us PHONE CONTACT FOR <br />l/; ~(f (IA~ 7)( ~ . <br />J-t /l'1~mlJ Yp/-r~i7ic ... <br />:5 } 0)/6 ,(/r1R..5 <2 Uert2J <br /> <br />PERMITTING <br /> <br />OWNER'S NAME <br /> <br />PHONE ?6J~()??-J-JY/ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />D/-;)b-J/-CO/O-//S ro -O(:OOIOBTAIN FROM <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION ~AIR <br />o DEMOLISH <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />D;ESCRIPTION OF WORK h / e... d?1/n?-.5 e ~4~ //' <br />BUILDING SIZE -7 ~,/l7;) SQUARE FOOTAGE ,;Juu L/ <br /> <br />HEIGHT <br /> <br />? 10 II <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br /> <br />$ <br /> <br />7f t:- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />. 1~ <br />W.R.E.C. <br /> <br />PERMITS REQUESTED <br /> <br />~ELECTRICAL <br />'~ PLUMBING <br />~CHANICAL <br />o GAS ~OOFING <br /> <br />AMP SERVICE <br /> <br />e( Progress Energy 0 <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION~BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />~)hffetJ~ ;~k< <br />---STATE CERT OR REGIST # C!?C !) s / ;;;,? h <br /> <br />ELECTRICIAN <br /> <br />COMPANY U/t:.r+-ilIG,)Jj'-' ~k c17d=_ <br />. <br /> <br />iP1 <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />jl/' .. . ..~ . .......- <br />P7 )~.f/ d-j1f!~ -s <br /> <br /> <br />~'*******************************************rr;**********;5****** <br /> <br /> <br />PLUMBER ~ ~ - ____~ COMPANY " ~ <br />SIGNATURE :::/,>'1 ~,-'~~~' STATE CERT OR REGIST # ~lt<6(QJ <br />t)~> <br /> <br />STATE CERT OR REGIST # <br /> <br />000 ;)r .1"7 E.c <br /> <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />~ ~---7 COMPANY;( e c, ('",l. C <br /> <br />~_ ~ .....?~~ / '__ STATE CERT OR REGIST # em CO c; h J' ~(j <br />/" c~./ ----. <br />***************************************************************** <br /> <br /> <br />.MECHANICAL <br />.>'/' <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />, <br />, <br /> <br />STATE CERT OR REGIST # <br /> <br />i'1.: .' <br />